“Integrating public health with high street revitalisation: A mixed methods analysis of local initiatives addressing the food environment”

Background Non-communicable diseases (NCDs) are the leading cause of years of life lost in England.

Unhealthy diets are amongst the greatest risk factors for the development of obesity and NCDs, and are known to be determined by the availability, accessibility and affordability of (un)healthy food and beverages.

While important, the implementation of local interventions aimed at promoting healthier food retail environments or 'high streets' can be challenging due diverging priorities between promoting health and stimulating economic growth. This has become particularly relevant in the context of the COVID-19 pandemic.

Aims and objectives This fellowship aims to investigate the integration of public health objectives with efforts to revitalise high streets in England.

It will focus on two research gaps: (1) how public health objectives can be achieved and prioritised in the context of increased incentives to support the local retail environment, and (2) how local authority practitioners and policymakers engage with private and third sector stakeholders in decision-making about the local food retail environment.

The objective are to: Synthesise existing evidence on the public health impact of initiatives to revitalise the retail environment, and the mechanisms by which initiatives are theorised to impact health and health equity.

Understand how the issue of high street revitalisation is framed by stakeholders in the public, private and third sector and the media in England.

Undertake comparative case studies of the Childhood Obesity Trailblazer programme in five English local authorities to: Explore local authority objectives, decision-making processes and activities surrounding the food environment and high street revitalisation.

Explore the extent to which Trailblazer initiatives integrate with objectives and activities aimed at supporting the high street, and the extent to which public health objectives are prioritised in each local authority context.

Identify public, private and third sector stakeholders involved in the Trailblazer programme, and explore their priorities, interests and engagement.

Synthesise findings from different research streams and develop a briefing document in collaboration with practitioners and the public.

Members of the public will be involved throughout the research project to ensure that the research objectives and activities are relevant to the concerns and priorities of the public in England.

Methods The fellowship objectives will be addressed using the following research methods: A mixed methods systematic review of primary research.

A mixed methods framing analysis of documents and online materials relevant to the revitalisation of the food retail environment.

Qualitative comparative case studies using documentary analysis, stakeholder interviews, stakeholder analysis and focus group discussions. An innovative application of meta-ethnography to synthesise research findings.

Anticipated Impact and dissemination The fellowship findings are anticipated to inform and support strategies to create healthy and prosperous retail environments, which is expected to benefit the public's health by making healthier choices more widely available, accessible and affordable.

Research outputs will also contribute to greater understanding of the optimal engagement between public, private and other stakeholders in decision-making that impacts health.

Findings will be disseminated through co-produced lay summaries, a briefing document sharing best practices, presentations and peer-reviewed publications.